go back

Utah rates for HCPCS L8039

Breast prosthesis, not otherwise specified

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.64 / $776.64 / $776.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.06 / $776.64 / $776.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00